PATHOLOGY

Your proper cancer treatment starts with accurate diagnosis.

OHSU student in lab

What you need to know

A pathologist is a doctor who examines cells under a microscope and writes a pathology report (a medical report about a piece of tissue, blood or organ). Pathology is a critical part of cancer care - 85% of the decisions that your doctors make are based on lab and pathology results. Pathology determines the initial diagnosis, including the stage and type of tumor. Determining the stage of a tumor involves measuring its size or where it has spread. To an increasing degree, pathology results can tell us which cancer treatment will work best. 

Legacy Cancer Institute partners with Cascade Pathology, a group of nationally recognized pathologists.

Experience results in expertise

All of our pathologists are board-certified and offer more than 250 years of combined, real-world experience in diagnosing all types of cancer. Most have additional certifications and extensive training in sub-specialties including breast, gastrointestinal and liver, genetics, gynecological and genital/urological pathology, hematopathology, cytopathology and molecular pathology. They examine cells, blood and molecules from the breast, gastrointestinal (GI), liver, gynecological and genital/urological areas of the body.

Cascade Pathology operates four centers that specialize in breast, gastrointestinal (GI) and liver, gynecologic and blood pathology.

Pathology services

Diagnosis

From the microscopic evaluation, the pathologist determines:
  • If the tumor is a cancer, its size and if it has spread
  • How different the cells are from normal cells 
  • The cancer “grade,” a rating of the tumor based on how abnormal cells look

A tumor grade is different than the cancer stage. Stage refers to the size and/or the extent of the original tumor and whether the cancer has spread in the body. Tumor grade is an indicator of how quickly a tumor is expected to grow and spread.

Genetic or molecular tests are also used to learn more about the cancer, these include:

  • Mismatch repair protein analysis for gastrointestinal and gynecological cancers
  • ALK/ROS/EGFR for lung cancers
  • BRAF for melanoma

Prognosis and treatment

Special tests help your doctor find the treatment options with the greatest chance of success. This is particularly true for breast, where the tests may include: 
  • A test that measures the growth rate of the cancer cells compared to normal cells
  • A test (ER/PR) to see whether a breast cancer will respond to hormone treatment
  • A test (HER2/neu) to determine whether a breast cancer has abnormal genes, to determine whether the tumor may respond to anti-HER2 antibody therapy (Herceptin)

During treatment

During and after surgery, the pathologist determines: 

  • Whether the whole cancer has been removed and the “margins are clean” (whether there is normal tissue completely surrounding the space where the tumor was removed)
  • Whether the cancer has spread to the lymph nodes

More support

You are not alone. Legacy offers support throughout your cancer journey, as well as care for your emotional, social and spiritual needs.

Nurse navigators
Legacy Cancer Healing Center 
Support groups and classes
Cancer rehabilitation 
Survivorship services

Meet our providers

Our outstanding group of nationally recognized pathologists serves Oregon, southwest Washington and receives referrals from all over the United States. Learn more about our pathologists.